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A depenable physician.

SERVICES

Doctor Clinic offers a wide range of care services to its patients. These range from medical referrals and Family/Preventive/Travel Medicine to Rheumatology and from Physiotherapy, Nutritonal Advice to Women/Men/Children related conditions. Through the attached pharmacy, the clinic can also facilitate COVID-19 vaccinations.

Services We Offer:

 

Offering a wide range of patient services:

  • General Health

  • Prevention & Wellness

  • Immunizations

  • Work/School/Travel Exams

  • Home Visits

  • Minor Ambulatory Procedures

  • Hypertension, Elevated Cholesterol

  • Mood Disorders: Anxiety, Depression

  • Respiratory Infections, Colds, Flu, Bronchitis

  • Migraines, Headaches

  • Chronic Disease Management

  • COPD & asthma care

  • Family Planning

  • Ear Syringing

  • Flu/ Pneumonia Immunization

  • Gynecology

  • Pain Management, Sports Injuries

  • Migraines, Headaches

  • Skin Conditions: Eczema, Acne, Rosacea, Psoriasis

CHECK IF YOU HAVE COVID-19

Please use the above self-assessment tool (developed by the BC Ministry of Health) to determine if you (or a family member) needs further assessment or testing for COVID-19.

General Health

Regular physical activity is important for overall health and can help to prevent and treat many chronic conditions, such as heart disease, diabetes and cancer.
Moving more and sitting a little less everyday can have tremendous benefits for people of every age and ability level. Only 16% of Canadian adults are active enough to meet the recommended levels of physical activity and get the health benefits.

Regular physical activity can:

  • Improve heart health

  • Strengthen bones and muscles

  • Improve sleep

  • Lower stress

  • Maintain brain health

  • Help control weight

  • Help you live longer

Canadian guidelines recommend that adults accumulate at least 150 minutes of moderate- to vigorous-intensity aerobic physical activity each week. Activities to strengthen your muscles, and improve your flexibility and balance are also recommended.
It is important to know that even small increases in your physical activity level can provide health benefits. Try to choose activities you enjoy and will continue to do.

Useful Resources

Women's Health

Breast Cancer

We Recommend the book: Intelligent Patient Guide to Breast Cancer by Olivotto, Gelmon, McCready and Kuusk

The BC Cancer Agency has a website with information on breast cancer.

You can download the Breast Cancer Companion Guide here

(and many other resources for breast cancer patients)

The Canadian Breast Cancer Foundation has information about breast cancer on their website

Breast Reconstruction information

Breastfeeding

Information about Vancouver Coastal Health breastfeeding resources can be found here

The Breastfeeding Buddy is a web based app, developed in collaboration with Perinatal Services BC and the Public Health Agency of Canada that has tips, tools and videos to help you with breastfeeding and more, from pregnancy to your baby’s first six months and beyond. It provides you with information and links to health resources in your community, and helps you keep track of your breastfeeding, baby’s sleep schedules and diaper changes, and scheduling if you express breast milk or provide alternate feedings. It’s an easy, fun, and educational tool designed to help you give your baby the very best start in life!

Healthlink BC info on breastfeeding

Cervical Cancer Screening (PAP Test)

The PAP test is a screening test for cervical cancer. All woman who has ever had sex should be screened. In BC, it is recommended that women should start having Pap tests at age 21 or 3 years after first sexual contact. Start with a Pap test every year for the first 3 years; then continue every 2 years if your results are normal until age 69, if your results are normal.

Almost all cervical cancers are caused by certain types of the Human Papilloma Virus (HPV) There is a vaccine available that can prevent some of the types of HPV most frequently linked to cancer and to genital warts. Speak to your doctor about whether the vaccine is right for you.

The BC Cancer Agency has an excellent webpage on cervical cancer screening and pap testing you can see here.

The Canadian Partnership Against Cancer  website also has some valuable information about the role of HPV and other issues

The best time to book your PAP test is midway between your periods, when you are not bleeding. If you would like to be tested for sexually transmitted infections at the same time as your PAP test, please mention this to your doctor. Please let the receptionist know if you would like to book a pap test as we allot extra time for the exam. We often use pap test visits as an opportunity to update all preventive health care screening for women and we call this a “well woman exam”.

Food Safety in Pregnancy

Although foodborne illnesses can affect everyone, pregnant women are more susceptible to certain foodborne bacteria, and they can be serious for both a pregnant woman and her baby. Proper food handling and avoiding certain foods can help decrease the risk of foodborne illness during pregnancy.

Recommendations for pregnant women include:

  • avoid raw/under-cooked meat & fish including sushi and raw oysters.

  • avoid unpasteurized milk or milk products, soft cheeses (feta, Brie, Camembert, blue-veined, Mexican queso fresco), deli foods, deli meats (cold cuts, salami, prosciutto etc.) pâté, refrigerated smoked seafood.

  • avoid raw or runny eggs or foods made with raw eggs such as eggnog, Caesar salad dressing, homemade ice cream & raw cookie dough.

  • avoid unpasteurized juice.

  • avoid raw sprouts (alfalfa, clover, mung bean etc.)

  • reheat leftovers, cold cuts, and hotdogs until steaming hot.

  • frequent hand washing before food preparation (especially after caring for child, changing diapers), wash fruits and vegetables.

  • clean and disinfect all food surfaces after food handling.

  • avoid eating shark, swordfish, king mackerel, tilefish, tuna steaks due to high levels of mercury (other fish, including canned tuna can be eaten in moderation: about 1-2 meals per week)

For more information see:

BC Centres for Disease Control

Healthlink BC

A helpful brochure from Government of Canada (see safe food handling for pregnant women) . You can also see all current food recalls at this site.

HPV VACCINE INFORMATION

Human papilloma virus (HPV) can infect different parts of the body. There are over 100 strains of the virus, some of which are transmitted sexually. HPV is the most common sexually transmitted infection in British Columbia and 70% of sexually active Canadians will contract it at some time. It is most common in youth and young adults. HPV can cause genital and anal warts. Certain strains also cause cervical, penile and anal cancers as well as cancers of the head and neck. There are vaccines available that protect against the most common cancer causing strains as well as the strains that most commonly cause genital warts. HPV vaccine is provided free for girls in grade 6 (girls those born after 1994 who did not receive the vaccine in school can get catch up vaccines at our office). The vaccine is also provided free for males age 9-26 who have sex with men (including those who may not be sexually active but are questioning their sexual orientation), are street involved or have HIV. The HPV vaccines are safe and well tolerated.

HPV vaccines are also recommended for other groups but not provided free of charge. Currently the National Advisory Committee on Immunization recommends HPV vaccine for all females age 9-45, all males aged 9-26 and men who have sex with men, regardless of age. Speak to your physician about whether it is recommended for you and to get a prescription.

Some helpful links for further information about the vaccine:

http://www.immunizebc.ca/diseases-vaccinations/hpv

http://www.hpvinfo.ca

Mammography

The Screening Mammography Program provides free screening mammograms for eligible BC women age 40 and up.

While no referral is required, we recommend women between the ages of 40-49 and 75+ come in the office to discuss the benefits and limitations of screening mammography with their doctors. A referral is required for women under age 40 who are at high risk of developing breast cancer.

How to book your mammogram:

  • There are mammogram clinics in every community. You can check the locations on their website: http://www.screeningbc.ca/Breast/

  • Call the Screening Programs Client Services Centre at 1-800-663-9203 or 604-877-6187

Please note it is not uncommon for women to be recalled for a second mammogram or an ultrasound following the initial screening test. Please call us if you are concerned about your results.

Information about breast density has been added to the BC Cancer Breast Screening website including a short animated educational video explaining the risks associated with breast density and what women can do if they have higher breast density. Research is ongoing to evaluate the role of ultrasound as a supplemental test for women with more dense breasts.

Menopause

The menopauseandu.ca website is a source of information for Canadian women approaching or in menopause or perimenopause. It is one element of a broader Menopause Education and Awareness Program initiated by the Society of Obstetricians and Gynaecologists of Canada (SOGC).

The North American Menopause Society, is a nonprofit scientific organization devoted to promoting women’s health and quality of life through an understanding of menopause. This site contains information on menopause, perimenopause, early menopause, menopause symptoms and long-term health effects of estrogen loss, and a wide variety of strategies and therapies to enhance health.

The Women’s Health Initiative (WHI) was a major 15-year research program to address the most common causes of death, disability and poor quality of life in postmenopausal women — cardiovascular disease, cancer, and osteoporosis.

HealthLink BC has created an online tool called “Menopause: Should I Use Hormone Therapy (HT)?”

It includes up-to-date facts compiled by a team of Canadian doctors, internists and geriatricians. The tool breaks down the “should-I-or-shouldn’t-I” conundrum into six sections that encourage women to learn the facts, compare their options and consider how they feel about using hormone therapy.

Osteoporosis

Information on osteoporosis can be found on:

Osteoporosis Canada website

National Osteoporosis Foundation website

Things you can do to reduce bone loss include:

  1. make sure you get enough calcium in your diet.

  2. take a vitamin D supplement.

  3. avoid smoking.

  4. get regular weight bearing exercise.

  5. limit alcohol intake

You doctor can help you determine if you should consider bone density testing by doing a fracture risk assessment. Things that will increase your risk score include a parent with a hip fracture, smoking, previous osteoporotic fracture, age over 65, smoking, higher alcohol intake, use of oral steroid medication or other medication known to cause bone loss, low weight and/or early menopause.

Pregnancy-General Information

We recommend the book Baby’s Best Chance which is available free for pregnant women in British Columbia. An online copy can be viewed here.

The Vancouver Division of Family Practice has a new website with easy-to access information for maternity patients.

The St. Paul’s Hospital Primary Care Maternity Service website.

The Family Practice maternity Service at BC Women’s Health Centre and Hospital website.

The Power to Push Campaign was launched in 2010 by BC Women’s Hospital & Health Centre. The goal of the campaign is to provide up-to-date resources for pregnant women and their families in British Columbia (BC), encouraging them to know their options, advocate for their choices, and push for the safest and best birth possible. The campaign also offers research-based information and resources to maternity care providers across BC to help them support every woman’s childbirth choices.

The Society of Obstetricians and Gynaecologists of Canada has a website that covers many important issues in pregnancy

Motherisk offers pregnant, planning and breastfeeding women answers to questions about morning sickness and the risk or safety of medication, herbs, diseases, chemical exposures and more. We also suggest you come in and speak to your physician if you have questions.

 Motherisk Helpline: 1-877-439-2744

For information on food safety in pregnancy see here

For information on prenatal genetic screening see here

For information on planning a pregnancy see here

 

Pacific Postpartum Support Society:

Pacific Post Partum Support Society has been supports mothers and their families experiencing postpartum/perinatal distress, depression and anxiety.

Postpartum mood disorders website from Ontario

Violence Against Women

Some resources for women experiencing violence:

Women Against Violence Against Women (WAVAW) Rape Crisis Centre website   has a crisis line

Battered Women’s Support Services website

Vancouver Rape Relief & Women’s Shelter website

BC Society of Transition Houses website

Legal Aid website

What Do I need To Think About Before I Get Pregnant?

  • start folic acid (0.4-1 mg/day)

  • have your immunity to German measles (rubella) checked by a blood test.

  • if you have not had chickenpox as a child, have your immunity to chickenpox (varicella) checked by a blood test.

  • some couples should be tested for inherited disorders that could affect the baby. Examples include.

        Tay Sachs disease and Canavan disease testing in people of Jewish decent

       Testing for hemoglobinopathies (such as thalassemia) in Asian, African, Mediterranean, Hispanic, Middle Eastern, East Indian nationalities

  • if there is a family history of birth defects, inherited diseases or recurrent miscarriage, speak to your doctor to see if any testing before pregnancy is advisable.

  • get tested for HIV if not done recently.

  • consider getting tested for sexually transmitted diseases.

  • obtain help to quit smoking and using street drugs.

  • stop or minimize alcohol consumption.

  • discuss the safety of any prescription, over-the-counter or herbal medications you use with your caregiver

  • avoid contact with cat litter if you think you might be pregnant.

  • eat well and exercise regularly.

  • if you are over or underweight, speak to your doctor for help in reaching and maintaining a healthy weight.

  • visit your doctor to discuss preparing for pregnancy.

Prenatal Genetic Screening

All pregnant women in BC can choose to have prenatal genetic screening. How far along you are in your pregnancy, your age, health, family history, and whether or not you are carrying more than one baby will influence which screening tests are available to you.

 

The British Columbia Prenatal Genetic Screening Program   has an excellent website that outlines the options for prenatal genetic screening available in BC.

Some women may choose to pay privately for a screen not available in the BC public medical system. There are two options: one is called First Trimester Screening (FTS) (done between 11 weeks and just under 14 weeks) and the other is called Non-Invasive Prenatal Testing (NIPT) (done as early as 10 weeks.) The website above also provides some information on the advantages and disadvantages of these private screening options.

We ask pregnant patients to book a separate appointment during their first trimester to discuss all genetic screening options with their doctor as there are many things to consider. We will provide information to help you choose if you wish to screen and which tests might be best for you.

SEXUAL & REPRODUCTIVE HEALTH

  • We recommend the Society of Obstetricians and Gynecologists of Canada’s (SOGC) website on sexual health issues: sexualityandu.ca  for information on contraception, sexually transmitted infections and other sexual health issues

  • The SOGC has developed an online patient questionnaire – itsaplan.ca – which includes 16 questions about contraceptive preferences, desire for pregnancy, medical history, and pregnancy risk behaviours. You can use this questionnaire as a tool to choose birth control methods that are right for you!

  • Sexual Health Education for children and teens here

  • You can get tested for sexually transmitted diseases at our office or arrange testing online here.

Children's Health

Baby Care Information

Caring for your newborn

Infant Nutrition

Immunization

Injury Prevention

Carseats/Booster seats

Safe Sleeping

The Canadian Paediatric Society has information on many topics including infant crying and colic, dental care and fluoride use, sun safety.

We recommend the book Baby’s Best Chance which is available free for pregnant women in British Columbia. An online copy can be viewed here.

Toddlers First Steps is an excellent resource for parents. We have paper copies available at the office and it can also be found online.

Care For Your Newborn

Vancouver Coastal Health has some resources available to support new mom's and their infants. You can read about them here

We recommend the book Baby's Best Chance which is available free for pregnant women in British Columbia. An online copy can be viewed here.

Sometimes parents worry that their newborn's stool is an abnormal colour. There is information available to help parents determine if tier infants stool is normal found here.

The Canadian Pediatric Society has a wealth of information about baby care on their website.

Child Car Seats

When used properly, child safety seats significantly reduce fatalities and serious injuries in a crash. Use of proper child restraints is the law! As children grow the requirements for car seats and proper restraint in a vehicle change.  We recommend the following sites for up to date information:

ICBC

BCAA

BC Ministry of Transport

Transport Canada

Canadian Paediatric Society

Consumer Reports

Concussion

The Concussion Awareness Training Tool (CATT) includes three toolkits providing training in the recognition, treatment, and management of concussion for:

1) Medical Professionals;

(2) Parents, Players, and Coaches; and

(3) School Professionals. It has some information sheets and videos useful for people who has suffered a concussion.

Head Lice & Bed Bugs

TREATING HEAD LICE

Vancouver Coastal Health provides information on treating head lice and wet combing see here

CDC provides the following information

The Canadian Paediatric Association information

Healthlink BC information

 

BED BUG INFESTATIONS

For information on bedbugs see here

Immunization for School Aged Children

Recommended Vaccines:

Grade 6:

  1. HPV 2 doses (girls only) note: also recommended for boys but currently not funded except for boys at increased risk *

  2. Meningococcal C Conjugate Vaccine

  3. Chicken pox and Hepatits B vaccine catch ups offered to those not previously fully immunized

Grade 9:

  1. Tetanus, Diptheria Pertussis (Tdap) Vaccine

*Note HPV vaccine is currently funded for males age 9-26 who have sex with men, are questioning their sexual identity, are street involved or have HIV

Infant Immunization

ROUTINE INFANT IMMUNIZATIONS OFFERED IN BRITISH COLUMBIA:


 

2 months

  1. DPTaP-Hib  (diphtheria, pertusis, tetanus, polio & H. influenza B) & Hepatitis B (INFANRIX hexa)

  2. Pneumococcal conjugate (Prevnar)

  3. Meningococcal group C conjugate (Menjugate or Neis-Vac-C)

  4. oral rotavirus vaccine

4 months

  1. DPTaP-Hib  (diphtheria, pertusis, tetanus, polio & H. influenza B) & Hepatitis B (INFANRIX hexa)

  2. Pneumococcal conjugate (Prevnar)

  3. oral rotavirus vaccine

6 months

  1. DPTaP-Hib  (diphtheria, pertusis, tetanus, polio & H. influenza B) & Hepatitis B (INFANRIX hexa)

  2. Influenza (during influenza season)

  3. Hepatitis A (Aboriginal children only)

12 months

  1. Measles, mumps, rubella (MMR)

  2. Meningococcal group C conjugate (Menjugate or Neis-Vac-C)

  3. Varicella (Varivax III or Varilrix)

  4. Pneumococcal conjugate (Prevnar)

  5. Influenza (during influenza season)

18 months

  1. DTaP-IPV-Hib (Pediacel)

  2. Influenza (during influenza season)

  3. Hepatitis A (Aboriginal children only)

4-6 years

  1. DTaP-IPV (Quadracel)

  2. Measles, mumps, rubella, varicella (MMRV)

  3. Influenza (during influenza season)

  4. Hepatitis A (Aboriginal children only)

We recommend the following booklet: Immunization: An important choice you make for your child

Infant Immunization

​
 

FOR FURTHER INFORMATION, VISIT THESE WEB SITES:

Canadian Paediatric Society: www.cps.ca

Immunization Action Coalition: www.immunize.org

Institute for Vaccine Safety (Johns Hopkins): www.vaccinesafety.edu

National Network for Immunization Info: www.immunizationinfo.org

World Health Organization: www.who.int/vaccines-diseases

Keep Kids healthy: www.keepkidshealthy.com

Bulletins on childhood immunization from the BC government can be found at: http://www.bchealthguide.org/healthfiles/index.stm

Infant Nutrition

Exclusive breastfeeding is recommended for the first six months of life for healthy infants born at term. Breast milk is the optimal food for infants, and breastfeeding (with complementary foods) may continue for up to two years and beyond. Breastfeeding reduces bowel (gastrointestinal) and respiratory infections.

Routine Vitamin D supplementation of 10 μg = 400 IU/day (20 μg = 800 IU/day in northern communities) is recommended for all breastfed full term infants until the diet provides a sufficient source of Vitamin D (about 1 year of age).

Excellent information from the Canadian Paediatric Society on many topics including breastfeeding, vitamin D supplementation, iron needs, colic, weaning your infant can be found on their website here

Injury Prevention

The leading cause of death and disability for Canadian children is injury. The good news is it doesn’t have to be that way. Many injuries can be prevented simply by using car and booster seats, bike helmets or by understanding a child’s abilities. In fact injuries are the leading cause of death for Canadians up to the age of 44.

Visit Parachute, a Canadian charitable organization dedicated to decreasing the rates of preventable injuries.

 

We also recommend BC Children’s Hospital’s information on child safety

BC Injury Research and Prevention Unit has useful information on their website.

TRAMPOLINES:

The Canadian Paediatric Society has the following position statement on trampoline use: Trampolines should not be used for recreational purposes at home (including cottages and temporary summer residences) by children or adolescents.

for more info see here and here

Parenting And Discipline

WE RECOMMEND THE FOLLOWING BOOKS:

  • Kids are Worth It: Giving Your Child the Gift of Inner Discipline by Barbara Colorosso (2001)

  • Children: the Challenge by Rudolf Dreikers (1992, first printed 1964)

  • Parenting Young Children: Systematic Training for Effective Parenting (Step) of Children Under Six by Don Dinkmeyer Sr.

  • The Parent’s Handbook: Systematic Training for Effective Parenting (STEP) (Paperback) by Don Dinkmeyer Sr.

​

Parenting workshops:

Westside Family Place

2819 West 11th Avenue

Tel: 604- 738-2819

We highly recommend the S.T.E.P Program: Systematic training for effective parenting for all parents. Courses are run by the following organizations:

Parent Support Services of BC

Burnaby Family Life Institute

The Adler Centre

Certificate Program in Parent Education:

If you have an interest in parenting and teaching, and a desire to reach out to the community, you might consider taking The Adler Centre’s Certificate Program in Parent Education- open to the General Public.

This program offers an opportunity to explore one of the most important jobs of our lives – parenting children, a chance to learn in an encouraging, intimate, and interactive way, and the tools and confidence to facilitate groups and it also offers the prestige of acquiring professional credentials.

For more information on prerequisites, dates, location, and the post-course certification procedure,  visit their website

STEP Parenting Workshop:

The Adler Centre’s STEP Parenting Workshops (Systematic Training in Effective Parenting) have been running for many years. Amongst many other things, you can expect to: find practical parenting strategies and tools, develop effective parenting patterns to reduce family conflict, learn why the ‘good parent’ and the ‘good child’ are myths, understand the purpose of behaviours such as temper tantrums and defiance, and learn how to encourage children to take responsibility, feel capable, and be respectful. not bad for an 8 session workshop!!

For more information, dates, and location, visit their website or contact them at: apabc@adler.bc.ca or call: 604-742-1818

 

HealthyFamilies BC helps British Columbians to better manage their own health and reduce chronic disease by focusing on four key areas: healthy eating, healthy lifestyles, resources for parents, and fostering healthy communities.

Safe Sleeping For Infants

For the first 6 months of life, we recommend that you place your infant on his or her back to sleep. Try to place your infants head in a different direction on

alternate days to avoid getting a flat head on one side. The ideal location for sleeping is in a crib in your room. Avoid putting extra soft material in the crib such as comforters, bumpers, stuffed animals etc. as they can increase the risk of SIDS (sudden infant death syndrome). Also try to avoid having your infant overheat. Second hand smoke contributes to the risk of SIDS (as well as many other health problems).

The Canadian Paediatric Society has information on their website about a variety of topics including safe sleep, preventing flat heads in infants who sleep on their backs, the user of pacifiers and many other sleep related topics.

 

After 6 months, you may want to try to train your child to fall sleep alone.  We recommended the book Solve Your Child’s Sleep Problems by Richard Ferber.

SEXUAL HEALTH EDUCATION RESOURCES FOR CHILDREN

  • Books we recommend for younger children and parents:
    The New Speaking of Sex: what your children need to know and when they need to know it by Meg Hickling (a local health educator and winner of many awards)

  • It’s So Amazing: a book about eggs, sperm, birth, babies and families by Robie Harris (for age 7 and up)

  • It’s Perfectly Normal by Robie Harris (for age 10 and up)

  • The Care and Keeping of You: the body book for girls by Valorie Schaefer

  • My Body, My Self for Boys and My Body, My Self for Girls by Lynda Madaras

  • Saleema Noon is a popular sexual health educator in the lower mainland. She runs workshops for kids of all ages and their parents.

  •  

  • Resources for teens:

  • Options for Sexual Health website. Opt has a Sex Sense Line : 1-800-SEX-SENSE (1-800-739-7367) or 604-731-7803 in the lower mainland

  • Smart Sex Resource for BC Centres for Disease Control

  • SOGC’s SexualityandU website

  • Fun video on consent

Youth Mental Health

New app from Foundry BC provides virtual wellness resources for youth

The Foundry BC app, which is powered by BC Children’s Hospital, provides assistance and services to people aged 12-24 in British Columbia. The app includes services such as drop-in and scheduled counselling and peer support. All services on the app are free, and do not require a referral to access. The app offers video, audio, and chat options. For more information, sign up for one of Foundry BC’s monthly Q&A sessions.

Men's Health

Prostate Health

Prostate Cancer Screening (PSA testing) . The BC Cancer Agency website has information on PSA screening found here. The also have a patient information sheet that reviews the pros and cons of screening found here.

Healthlink BC has an information sheet on PSA screening

Testicular Health

HealthLink  information sheet on testicular self examination

Advance Care Planning: Representation Agreements And Living Wills

Advance care planning helps you have a say about the health care you would like to receive if you get very sick and cannot speak for yourself. It is a way for you to reflect on your personal values, wishes and beliefs to make your own future health care decisions. Vancouver Coastal Health has created a new website to help people navigate advance care planning.

The BC government has a website on Advanced Care Planning here

You can download a free copy of “My Voice” the Advance Care Planning Guide from the website. The new guide is a workbook that contains information on how to do advance care planning and also forms for making a personal advance care plan.

A Representation Agreement permits the patient to appoint both a financial representative and a health representative (guide available at www.trustee.bc.ca). A Power of Attorney (with an enduring clause) is the recommended legal document to appoint a financial representative.

Public Guardian and Trustee of British Columbia

The Canadian Hospice Palliative Care Association’s “Speak Up” website provides excellent tools to help people and their families make decisions and plan for future health care. Another link to there material is here.

Prepare for you Care is an online program to help people make medical decisions

Cervical Cancer Screening (PAP Test)

The PAP test is a screening test for cervical cancer. All woman who has ever had sex should be screened. In BC, it is recommended that women should start having Pap tests at age 21 or 3 years after first sexual contact. Start with a Pap test every year for the first 3 years; then continue every 2 years if your results are normal until age 69, if your results are normal.

Almost all cervical cancers are caused by certain types of the Human Papilloma Virus (HPV) There is a vaccine available that can prevent some of the types of HPV most frequently linked to cancer and to genital warts. Speak to your doctor about whether the vaccine is right for you.

The BC Cancer Agency has an excellent webpage on cervical cancer screening and pap testing you can see here.

The Canadian Partnership Against Cancer  website also has some valuable information about the role of HPV and other issues

The best time to book your PAP test is midway between your periods, when you are not bleeding. If you would like to be tested for sexually transmitted infections at the same time as your PAP test, please mention this to your doctor. Please let the receptionist know if you would like to book a pap test as we allot extra time for the exam. We often use pap test visits as an opportunity to update all preventive health care screening for women and we call this a “well woman exam”.

Exercise And Fitness

Check out the award winning video on the benefits of exercise by Dr. Mike Evans

Some people find MyFitnessPal app & website a good way to track intake and activity and it will sync with FitBit scales and activity trackers.

Healthy Heart

We recommend this new risk calculator to calculate your “cardiovascular age”.  You will need a copy of your most recent lab results to complete your profile-ask us for a copy at  your next visit.

Infections And Antibiotics

We highly recommend Do Bugs Need Drugs? website -a community program for the wise use of antibiotics for information on managing common infections, handwashing and preventing infections and antibiotic resistance.

HPV VACCINE INFORMATION

Human papilloma virus (HPV) can infect different parts of the body. There are over 100 strains of the virus, some of which are transmitted sexually. HPV is the most common sexually transmitted infection in British Columbia and 70% of sexually active Canadians will contract it at some time. It is most common in youth and young adults. HPV can cause genital and anal warts. Certain strains also cause cervical, penile and anal cancers as well as cancers of the head and neck. There are vaccines available that protect against the most common cancer causing strains as well as the strains that most commonly cause genital warts. HPV vaccine is provided free for girls in grade 6 (girls those born after 1994 who did not receive the vaccine in school can get catch up vaccines at our office). The vaccine is also provided free for males age 9-26 who have sex with men (including those who may not be sexually active but are questioning their sexual orientation), are street involved or have HIV. The HPV vaccines are safe and well tolerated.

HPV vaccines are also recommended for other groups but not provided free of charge. Currently the National Advisory Committee on Immunization recommends HPV vaccine for all females age 9-45, all males aged 9-26 and men who have sex with men, regardless of age. Speak to your physician about whether it is recommended for you and to get a prescription.

Some helpful links for further information about the vaccine:

http://www.immunizebc.ca/diseases-vaccinations/hpv

http://www.hpvinfo.ca

Mammography

The Screening Mammography Program provides free screening mammograms for eligible BC women age 40 and up.

While no referral is required, we recommend women between the ages of 40-49 and 75+ come in the office to discuss the benefits and limitations of screening mammography with their doctors. A referral is required for women under age 40 who are at high risk of developing breast cancer.

How to book your mammogram:

  • There are mammogram clinics in every community. You can check the locations on their website: http://www.screeningbc.ca/Breast/

  • Call the Screening Programs Client Services Centre at 1-800-663-9203 or 604-877-6187

Please note it is not uncommon for women to be recalled for a second mammogram or an ultrasound following the initial screening test. Please call us if you are concerned about your results.

Information about breast density has been added to the BC Cancer Breast Screening website including a short animated educational video explaining the risks associated with breast density and what women can do if they have higher breast density. Research is ongoing to evaluate the role of ultrasound as a supplemental test for women with more dense breasts.

Preventive Health Care

Preventive health care is important and at Bayswater Family Practice we work hard to make sure each patient is up to date in terms of recommended evidence-based screening and preventive health care procedure such as immunizations.

Annual check ups aren’t always necessary but we do try to see our patients regularly to make sure that recommended discussions (such as asking about smoking and alcohol intake), examinations (such as pap tests, prostate exams and blood pressure checks), lab and xray tests (such as diabetes screening, stool testing for colon cancer, and mammograms) as well as procedures (such as vaccinations) are all kept up to date.

There is good information about recommended preventive health care interventions at the following places:

Choose Wisely Canada website here

Dr. Mike Evans cartoon video on screening test here

The Canadian Task Force on Preventive Health Care is used by many practitioners to guide what preventive health interventions are supported by evidence.  They have some interesting information on their website here. We particularly find their charts on the risks and benefits of mammogram screening useful in making decisions about when to screen. Look in the tools section.

 

CANCER SCREENING

For information on BC’s colon cancer screening program please see the BC Cancer Agency site here and Vancouver Coastal Health’s site here

For cervical cancer screening see here

For breast cancer screening see here

For prostate cancer screening see here

SEXUAL & REPRODUCTIVE HEALTH

We recommend the Society of Obstetricians and Gynecologists of Canada’s (SOGC) website on sexual health issues: sexualityandu.ca  for information on contraception, sexually transmitted infections and other sexual health issues

The SOGC has developed an online patient questionnaire – itsaplan.ca – which includes 16 questions about contraceptive preferences, desire for pregnancy, medical history, and pregnancy risk behaviours. You can use this questionnaire as a tool to choose birth control methods that are right for you!

Sexual Health Education for children and teens here

You can get tested for sexually transmitted diseases at our office or arrange testing online here.

Skin Care

  • The SkinCareGuide Network of dermatology-related websites was founded by a group of international dermatologists. It provides Skin Care Advice Including: Skin Treatments For Your Skin Rash, Dry Skin, Wrinkles And Learn How To Improve Other Skin Problems Like Acne, Herpes, Skin Cancer, Eczema, Psoriasis, And Other Skin Conditions

  • The Eczema Society of Canada has a helpful website.

  • Check out BC Cancer Agency’s Suntips website about decreasing the risk of skin cancer

  • The Canadian Dermatology Association has information about skin health on their website

Prevention & Wellness

Canadian guidelines recommend that adults accumulate at least 150 minutes of moderate- to vigorous-intensity aerobic physical activity each week. Activities to strengthen your muscles, and improve your flexibility and balance are also recommended.
It is important to know that even small increases in your physical activity level can provide health benefits. Try to choose activities you enjoy and will continue to do.

Immunizations

The seasonal influenza vaccine protects against viruses that cause influenza, often called the flu. The vaccine does not protect against other viruses or bacteria that cause colds or stomach illness, such as ‘stomach flu’. The H1N1 antigen is included in the seasonal flu vaccine this year.

Kids need a second dose:

Children under 9 years of age who have never had a regular seasonal influenza vaccine also need 2 doses, 1 month apart.

Pregnant women:

Influenza vaccination in pregnancy is safe. Please inform us if you are pregnant.

Who should not receive a flu vaccine:

  • Children under 6 months of age

 

  • People who have had a life threatening reaction to a previous dose of vaccine.

 

  • Those with a past history Guillain-Barre syndrome, which occurred within 8 weeks of receiving a previous dose of influenza vaccine.

 

  • Note: People with severe egg allergy (including anaphylaxis) can have any influenza vaccine.

Additional contraindications to FluMist:

  • Those with weakened immune systems, severe asthma, or active wheezing in past 7 days

 

  • Children receiving ASA-containing therapy

 

  • Infants <2 years

 

  • Pregnant women

  • History of egg allergy

Influenza vaccine for seniors 65+:

Free vaccines for community dwelling seniors include Fluad® (an adjuvanted vaccine that produces an enhanced immune response), Fluviral® or Agriflu®. Fluzone HD® is available for purchase without prescription at select pharmacies and the VCH Travel Clinic ($80).

Adverse reactions:

Local reactions such as soreness at the injection site occur for up to 2 days in 30% of recipients.

 

Systemic reactions such as fever, aching muscles and fatigue may occur 6-12 hours after vaccination and last 1-2 days especially in persons receiving the vaccine for the first time. Influenza vaccine cannot cause the flu because it does not contain a live virus.

Serious Reactions:

Guillain-Barré Syndrome (GBS), a form of paralysis, is usually temporary and can occur after some common infections. GBS may be associated with influenza vaccine in about 1 per million recipients.

 

During the 2000 influenza season, some people who got the influenza vaccine had

 

  • reaction called oculo-respiratory syndrome (ORS). ORS involved eye redness, and in some people, a cough, sore throat or breathing symptoms. Most people who had ORS can be safely vaccinated again, and there have been few reports since 2000.

Vaccine safety:

Influenza vaccine may safely be given at the same time as other vaccines. Influenza vaccine contains a very small amount of thimerosal as a preservative. Scientific evidence has proven it to be safe for use in adults, children and pregnant women.

Pneumococcal vaccine

Those over age 65 as well as many patients age 2-64 with chronic medical conditions are also eligible for one time pneumococcal vaccine-ask the doctor if you think you may be eligible

Work/School/Travel Exams

At Medicine Shoppe and Clinic, we can take care of your Childs’ work or school physicals. These are crucial because they insure your loved one stays in good health, as well as protecting those around them. Every child, teenager, or young adult should receive a physical examination before starting school or even a new job. A typical physical exam includes gathering medical history, observing, and evaluating posture, mobility, joints, and organs, as well as vision and hearing tests. There are many good reasons for an individual to have a medical examination prior to attending school or work. All involve protecting individual children and their classmates.

During a school or work physical, we evaluate the following:

  • Height and weight

  • Pulse and blood pressure

  • Posture, mobility, muscle strength.

  • Ears, nose, and throat.

Travel Exams

The best time to make an appointment for a travel exam is at least 4-6 weeks before your trip. Recommendations for vaccines or medications depend on many different factors that are specific to each person. This includes where you are traveling, the length of your trip, any activities you may do, and additional personal factors such as age, medical and immunization history, as well as one's current medical state. We will provide the best advice depending on your child's situation. If your child was recently sick or if they find themselves sick at the time of planned travel, be sure to notify us.

Traveling while they are sick may put their health at risk or put others around them at risk for getting sick.

 

Need to schedule a work, school, or travel exam?

Please call our office at (604) 385-5865

Travel Health

For travel health information:

We recommend the Public Health Agency of Canada website for up to date travel information.

The Government of Canada provides travel information on its website

The Centers for Disease Control & Prevention (CDC) in the USA also has a comprehensive website

The World Health Organization Travel and Health website

Healthlink BC travel information

CDC’s info on travel with children here

Minor Surgical Procedures

Medicine Shoppe and Clinic offers Minor Surgical Procedure services such as:

  • excision and biopsy to remove or rule out carcinoma.

  • temporal artery biopsy

  • nerve biopsy

  • muscle biopsy

  • varicose vein ligation

  • removal of cyst

  • drain removal.

  • tube removal or re-positioning

  • inflamed dermal and epidermal cyst

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